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      Slug, a Cancer‐Related Transcription Factor, is Involved in Vascular Smooth Muscle Cell Transdifferentiation Induced by Platelet‐Derived Growth Factor‐BB During Atherosclerosis

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          Abstract

          Background

          Heart attacks and stroke often result from occlusive thrombi following the rupture of vulnerable atherosclerotic plaques. Vascular smooth muscle cells ( VSMCs) play a pivotal role in plaque vulnerability because of their switch towards a proinflammatory/macrophage‐like phenotype when in the context of atherosclerosis. The prometastatic transcription factor Slug/Snail2 is a critical regulator of cell phenotypic transition. Here, we aimed to investigate the role of Slug in the transdifferentiation process of VSMCs occurring during atherogenesis.

          Methods and Results

          In rat and human primary aortic smooth muscle cells, Slug protein expression is strongly and rapidly increased by platelet‐derived growth factor‐BB (PDGF‐ BB). PDGFBB increases Slug protein without affecting mRNA levels indicating that this growth factor stabilizes Slug protein. Immunocytochemistry and subcellular fractionation experiments reveal that PDGFBB triggers a rapid accumulation of Slug in VSMC nuclei. Using pharmacological tools, we show that the PDGFBB–dependent mechanism of Slug stabilization in VSMCs involves the extracellular signal‐regulated kinase 1/2 pathway. Immunohistochemistry experiments on type V and type VI atherosclerotic lesions of human carotids show smooth muscle–specific myosin heavy chain–/Slug‐positive cells surrounding the prothrombotic lipid core. In VSMCs, Slug si RNAs inhibit prostaglandin E2 secretion and prevent the inhibition of cholesterol efflux gene expression mediated by PDGFBB, known to be involved in plaque vulnerability and/or thrombogenicity.

          Conclusions

          Our results highlight, for the first time, a role of Slug in aortic smooth muscle cell transdifferentiation and enable us to consider Slug as an actor playing a role in the atherosclerotic plaque progression towards a life‐threatening phenotype. This also argues for common features between acute cardiovascular events and cancer.

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          Most cited references50

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          A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association.

          This report is the continuation of two earlier reports that defined human arterial intima and precursors of advanced atherosclerotic lesions in humans. This report describes the characteristic components and pathogenic mechanisms of the various advanced atherosclerotic lesions. These, with the earlier definitions of precursor lesions, led to the histological classification of human atherosclerotic lesions found in the second part of this report. The Committee on Vascular Lesions also attempted to correlate the appearance of lesions noted in clinical imaging studies with histological lesion types and corresponding clinical syndromes. In the histological classification, lesions are designated by Roman numerals, which indicate the usual sequence of lesion progression. The initial (type 1) lesion contains enough atherogenic lipoprotein to elicit an increase in macrophages and formation of scattered macrophage foam cells. As in subsequent lesion types, the changes are more marked in locations of arteries with adaptive intimal thickening. (Adaptive thickenings, which are present at constant locations in everyone from birth, do not obstruct the lumen and represent adaptations to local mechanical forces). Type II lesions consist primarily of layers of macrophage foam cells and lipid-laden smooth muscle cells and include lesions grossly designated as fatty streaks. Type III is the intermediate stage between type II and type IV (atheroma, a lesion that is potentially symptom-producing). In addition to the lipid-laden cells of type II, type III lesions contain scattered collections of extracellular lipid droplets and particles that disrupt the coherence of some intimal smooth muscle cells. This extracellular lipid is the immediate precursor of the larger, confluent, and more disruptive core of extracellular lipid that characterizes type IV lesions. Beginning around the fourth decade of life, lesions that usually have a lipid core may also contain thick layers of fibrous connective tissue (type V lesion) and/or fissure, hematoma, and thrombus (type VI lesion). Some type V lesions are largely calcified (type Vb), and some consist mainly of fibrous connective tissue and little or no accumulated lipid or calcium (type Vc).
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            Smooth muscle cell fate and plasticity in atherosclerosis

            Current knowledge suggests that intimal smooth muscle cells (SMCs) in native atherosclerotic plaque derive mainly from the medial arterial layer. During this process, SMCs undergo complex structural and functional changes giving rise to a broad spectrum of phenotypes. Classically, intimal SMCs are described as dedifferentiated/synthetic SMCs, a phenotype characterized by reduced expression of contractile proteins. Intimal SMCs are considered to have a beneficial role by contributing to the fibrous cap and thereby stabilizing atherosclerotic plaque. However, intimal SMCs can lose their properties to such an extent that they become hard to identify, contribute significantly to the foam cell population, and acquire inflammatory-like cell features. This review highlights mechanisms of SMC plasticity in different stages of native atherosclerotic plaque formation, their potential for monoclonal or oligoclonal expansion, as well as recent findings demonstrating the underestimated deleterious role of SMCs in this disease.
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              HDL, ABC transporters, and cholesterol efflux: implications for the treatment of atherosclerosis.

              High-density lipoprotein (HDL) has been identified as a potential target in the treatment of atherosclerotic vascular disease. The failure of torcetrapib, an inhibitor of cholesteryl ester transfer protein (CETP) that markedly increased HDL levels in a clinical trial, has called into doubt the efficacy of HDL elevation. Recent analysis suggests that failure may have been caused by off-target toxicity and that HDL is functional and promotes regression of atherosclerosis. New studies highlight the central importance of the ATP-binding cassette (ABC) transporters ABCA1 and ABCG1 in reducing macrophage foam cell formation, inflammation, and atherosclerosis. A variety of approaches to increasing HDL may eventually be successful in treating atherosclerosis.
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                Author and article information

                Contributors
                isabelle.limon@sorbonne-universite.fr
                Journal
                J Am Heart Assoc
                J Am Heart Assoc
                10.1002/(ISSN)2047-9980
                JAH3
                ahaoa
                Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
                John Wiley and Sons Inc. (Hoboken )
                2047-9980
                21 January 2020
                21 January 2020
                : 9
                : 2 ( doiID: 10.1002/jah3.v9.2 )
                : e014276
                Affiliations
                [ 1 ] Institut de Biologie Paris‐Seine (IBPS) Biological Adaptation and Ageing UMR 8256 Sorbonne Université Paris France
                [ 2 ] INSERM Saint‐Antoine Research Center Sorbonne Université Paris France
                [ 3 ] National Institute for Health and Medical Research (INSERM) Faculté de Médecine Pitié Salpétrière UMR‐S 1166 ICAN Sorbonne Université Paris France
                [ 4 ] CIMI‐Paris INSERM U1135 Faculté de Médecine Sorbonne‐Université Site Pitié‐Salpêtrière Sorbonne Université Paris France
                [ 5 ] INSERM UMR_S 933 Sorbonne Université Paris France
                [ 6 ] Université de La Réunion Diabète, Athérothrombose, Thérapies, Réunion, Océan Indien (UMR DéTROI U1188) – ‐CYROI‐ Sainte Clotilde La Réunion
                Author notes
                [*] [* ] Correspondence to: Isabelle Limon, PhD, IBPS, CNRS UMR 8256, Sorbonne Université, 7 Quai Saint Bernard, Bâtiment A 5 ème étage, Case 256, 75252 Paris Cedex 05, France. Email: isabelle.limon@ 123456sorbonne-universite.fr
                [†]

                Dr Ledard and A. Liboz contributed equally to this work as first authors.

                [‡]

                Pr Limon and Dr Glorian contributed equally to this work as last authors.

                Article
                JAH34580
                10.1161/JAHA.119.014276
                7033846
                31959031
                9aef810b-11ef-4736-b06b-dc5c13943a1b
                © 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 12 August 2019
                : 18 September 2019
                Page count
                Figures: 8, Tables: 0, Pages: 17, Words: 8653
                Funding
                Funded by: Sorbonne Université
                Funded by: Centre National de la Recherche Scientifique , open-funder-registry 10.13039/501100004794;
                Categories
                Original Research
                Cardio‐Oncology Spotlight
                Original Research
                Custom metadata
                2.0
                21 January 2020
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.7.5 mode:remove_FC converted:12.02.2020

                Cardiovascular Medicine
                atherogenesis,inflammation,vascular smooth muscle,atherosclerosis,vascular disease

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